The ‘C’ word—colic—can be a parent’s worst nightmare. Crying for hours on end for no apparent reason can challenge the patience of even the most dedicated parents.
Parents know that when their babies cry it is a call to action, a sound made for attention when other, more subtle, means of communication have failed.
Sucking sounds, rooting, and squirming are a baby’s way of saying, “Feed me.” Fussing and fretting signal, “I’m lonely. Hold me,” or “Diaper change, please.” Parents soon learn to identify the subtle cues that let them know what their babies need and when they need it. Research shows that babies whose needs are consistently met seldom cry. But what about the 10–20 percent of babies who develop a pattern of crying with no obvious cause?
Does your baby have colic?
The generally accepted definition of colic was first reported by Wessel and colleagues in a 1954 issue of Pediatrics. According to the so-called “rules of threes,” colic is “crying or fussing for more than 3 hours a day, for more than 3 days a week, and for more than 3 weeks, in an infant who is well-fed and otherwise healthy.” Colic typically develops around 2–4 weeks of age, and it usually resolves by 3–4 months.
While “the rule of threes” is a handy guideline, the most important characteristic of colic is “persistent excessive crying.” Colic affects the parent, as well as the child. Frustration and exhaustion can lead to feelings of failure, low self-esteem, powerlessness, depression, and even anger. Ultimately, colic affects the parent-child relationship.
“Normal” infant crying is often predictable, triggered by certain circumstances, and preventable provided pre-cry cues are answered. In contrast, colic is persistent, piercing, and seemingly painful. The crying spells can occur at any time, although many parents report that they usually occur in the evening.
Signs of colic
Here are some telltale signs your baby may be suffering from colic:
- persistent, inconsolable crying
- alternate flushing and paling of the baby’s face
- clenched fists, curled toes, and legs flexed towards the abdomen
Not all persistent crying is colic. Colic does not cause fever; fever is usually a sign of infection. Also, babies with colic do not show signs of pain as soon as they awaken; babies who start to cry as soon as they awaken should be checked for other causes.
What can you do?
If your baby cries for extended periods of time, use a three-step approach: search for triggers; keep soothing; wait it out. The first two require a combination of detective work and trial-and-error, while the third requires patience and understanding.
1. Search for triggers
Theories about the causes of colic generally point to either an immature digestive system or an immature nervous system. With a bit of effort, you may be able to identify your baby’s triggers and strategies for relieving her discomfort. Common triggers include:
- Gas. The relationship between colic and gas is unclear—is your baby crying because his stomach is full of air or is his stomach full of air because he has taken in extra air while crying? In some ways, knowing which came first isn’t important. If your baby is crying for a prolonged period of time, he’s sure to draw air into his digestive tract. Burp your baby often during feedings, and during colicky spells. Use a combination of gentle pats and upward strokes on his back.
- Poor positioning. Try positioning your baby in a sitting or semi-upright position when breastfeeding, or recline back so your baby is tummy-to-tummy with you. If you are using bottles, practice “paced bottle-feeding” with your baby, and experiment with nipple types and sizes, as a switch may reduce the amount of air your baby draws in with each feeding.
- Food intolerances. Keep a dietary log. There’s no reason to stop breastfeeding if your baby has colic; in fact, switching a colicky baby to artificial infant formula can make the symptoms worse. However, you will want to write down the foods you consume each day, since it is possible that some foods can trigger colic in your baby. Look for patterns. Are your baby’s crying spells worse after you’ve had dairy products? Eliminating dairy from your (or your baby’s, if formula-fed) diet can make a difference, although you may not notice a difference until all of the milk proteins are out of your system. This could take a couple of weeks. Think, too, of other common food-sensitivity culprits, such as caffeine and spicy foods. Avoid any suspect foods for at least one week, to see if there are changes in your baby’s behavior.
- Meal size. Sometimes, colic is caused by over-feeding. Try feeding your baby smaller, more frequent meals. Offer just one breast per feeding. This gives your baby a low-volume, low-sugar, high-fat meal rather than a high-volume, high-sugar, low-fat one. High-sugar meals produce more gas, and increase the risk for colic. Feed from the other breast for the next feeding, and continue to alternate. Shorter feedings may also help to address another theorized cause of colic: immature jaw development.
- Environment. Some medical experts suggest that colic is caused by an immature nervous system in infants who are not yet able to cope with the amount of stimulation in their environment. An overload of sights, sounds, and movement may build up by the end of the day when colic is typically at its peak. Giving your baby scheduled one-on-one quiet time may help to head off the end-of-day meltdown.
2. Soothe the pain
Unfortunately, colic often begins at a time when parents are learning how to care for their infant. Often, they worry that they are doing something wrong to cause their baby such distress. Well-meaning friends and relatives, with all-too-quick advice about what they should do to stop the crying, can only exacerbate these feelings.
Parents with colicky babies need to devise a flexible set of soothing strategies, recognizing that what works for one family may not work for theirs, and that what works for their baby one time may not work the next. Suggested soothers:
- Wear your baby. Babywearing has many benefits, and babies who are held close for long periods of time tend to cry less often. Being snuggled against your body and feeling the motion of your movement should provide some comfort to your baby, even if his discomfort persists. In fact, in cultures where babies are carried in slings for much of the day, colic is rare.
- The “colic hold.” Hold your baby straddled over your arm so that your forearm applies gentle pressure on his abdomen. His cheek will rest against your palm. This is something like carrying a football; some childbirth educators refer to it as the “airplane” hold. The warm pressure may help move any excess gas from your baby’s digestive system. You can rock back and forth while holding your baby in this manner. Another option? Lay your baby tummy-down across your knees and gently pat his back.
- Warmth. Your baby’s abdomen may feel better if you apply a warm compress, such as a warm washcloth or a warm (not hot) water bottle. Try taking a warm bath together, holding your baby on your chest, skin-to-skin.
- Massage. Gentle strokes may help calm your baby and settle his stomach. See our quick how-to guide on baby massage. You can also stimulate your baby's digestive system with the "I love you" massage.
- Turn on some “white noise.” Constant sound or vibration may help. Some babies are soothed by the sound of a vacuum cleaner, a fan, a dishwasher, a white noise machine, or a clothes dryer. (But never put your baby on top of the washer or dryer; his crying or the appliance’s shaking could cause him to fall.)
- Go for a walk or a drive. Slip your baby into a sling or baby carrier, and get some fresh air; it might do you both good! Alternately, some babies relax on car rides. The only downside? He may become so acclimated to sleeping in a moving car that that will be the only place he’ll sleep.
3. Wait it out
Unfortunately, for many babies, the only “treatment” for colic is time. It will go away on its own, eventually, but it can take weeks or months. In the meantime, it is important to develop strategies to care for yourself, your baby, and your relationship with him while you wait.
It may help to remember that colic is temporary and will not cause any long-term damage to your baby. Your baby is not telling you that he doesn’t love you, or that he is not well cared for. Baby expert and author Elizabeth Pantley suggests the following cooping strategies:
- Plan your outings with your baby around the colicky times. The change of pace may help keep your baby happy.
- Take advantage of offers for help from others, who can at least give you a break long enough for a shower or a walk to clear your head.
- Reorder your priorities. Only do the things that have to be done, and only the things that only you can do.
- Talk to other parents with colicky babies. It helps to know you are not the only parent on the planet with a colicky baby.
No matter how frustrated, upset, or anxious you become, never shake your baby in an attempt to stop his crying. Shaken Baby Syndrome (SBS) can result in permanent brain damage. (You can learn more about SBS here.) If you begin to feel out of control, it is better to put your baby down in a safe place (such as a crib or playyard) and walk into another room for a few minutes, step outside for a quick breath of fresh air, or call someone for help.
When should you contact a doctor?
Remember, if your baby is running a fever or showing signs of illness, his crying may not be colic. Contact his pediatrician right away. Sometimes, persistent crying may be caused by medical conditions such as gastrointestinal disorders and allergies. If you suspect these problems, you will want to identify the cause so you can treat it sooner rather than later. Discuss your baby’s crying patterns with his doctor at your next visit. A pediatrician should be able to discuss the benefits and risks of any over-the-counter and/or herbal “colic” preparations (including teas, anti-gas medications, antacids, antihistamines, probiotics, and more).
The good news is that there is a light at the end of the tunnel. Colic does go away, and parents do survive. Your baby is looking forward to feeling better as much as you are.